To Lithium or not to Lithium – that is the Question

Disclaimer: I am not a medical professional and this is no way should be taken as medical advice. Always consult your medical team before altering your prescription routine. Thank you!

It honestly took me a total of five or so years before finding the perfect cocktail of drugs to keep me stable, along with the patient help of my lovely psychiatrist, whom both my partner and I are in love with. Especially in Canada, psychiatrists are often overloaded with patients and the most I’ve seen only had time to see me for 15 minutes: basically a quick dose of, “How are your meds doing?”, “Are you depressed? Are you suicidal?” Good. Appointment done and then you are sent on your merry way.

It took me a long time to find a psychiatrist that I am happy with. And she is honestly a god-send. She has been seeing me for around three years now and is quick to call me on my bullshit, as all psychiatrists should be able to do after seeing you for a long enough time. Bullshit being: the same limiting patterns of your belief fthat keeps you in an unhealthy state of mind, ie. Depression whispering: I will never get better or on the flipside, Mania: I am okay, everything is working out perfectly, I need to stop taking all of my meds to prove to the world that I am cured!

It is a very long process of observation, trying out different medications, some more expensive than others, and testing to see how my body and mind responds to it. Up until my pregnancy, I was on a combination of stimulants and anti-depressants to combat my depression. The two main indicators of my depression is chronic fatigue and anhedonia (inability to feel pleasure). Those who know me well know very well how passionate and energetic I am when it comes to my daily life, (from movies to books, to music, in fact, I usually have multiple projects going on at the same time). So it is very alarming for me and my loved ones (especially my husband) when I start spending my days in bed, not going out, not eating, and not doing anything.

The stimulants help me stay focused, not to mention focuses my energy in order to be productive on a day-to-day basis. Having ADHD as well makes it hard for me to focus, so the medication helps me keep on track and complete projects into fruition. The anti-depressant keeps my serotonin in production, and is there to help me keep on baseline.

I also have fibromyalgia (chronic musculoskeletal pain, accompanied by sleep, fatigue and memory and mood issues), when stress and depression hits – for this I am on an anti-seizure drug to help with the pain.

PTSD symptoms are nightmares and flashbacks. To combat these, I am on an experimental medication typically used for high blood pressure, but has also showed beneficial in reducing nightmares and flashbacks.

Lastly, I am on night medications, a combination of anti-psychotics and mood stabilizers for sleep.

My psychiatrist and I knew that the most difficult time for me during my pregnancy would be weaning off the medications I was currently on. For this, we consulted a pregnancy specialist at the Women’s College Hospital to see what would be best for my health and the baby’s in the long run. Eventually, we decided to stay on the anti-depressant, anti-psychotic and mood stabilizer as the most skeletonized version of my treatment.

All in all, 22 weeks in, I am feeling great, but weaning off the stimulant was the worst, and it is still taking a toll in my productivity and daily life to this day. The weeked I went off my stimulant, I spent over 72 hours in bed, and still could not get rid of the feeling of lethargy. Combined with my fibromyalgia that I was now no longer getting treated for, I felt as if my sentence for the rest of this pregnancy was bound in my bed.

For the first few weeks, due to pain all over my body (back pain, round ligament pain, migraine, leg pain – I am sure some of this new pains were pregnancy-related, adding to the old pain from fibromylagia), I stayed in bed all day, only stretching my legs every now and then to migrate myself to the couch, feed myself, and spend the rest of the day sleeping. I honestly felt like waking up and exisiting was too painful. I was just trying to spend the hours as pain-free as possible (by sleeping) and nursing my baby as much as I can by feeding myself.

It felt like good old depression came back – just the physical symptoms, not the emotional sadness / emptiness, which was a very weird thing to come to terms with. For me, depression had always been two-fold: I am in physical and emotional pain. But this time around, I was in pain but felt fulfilled and happy. It was still depressing, in every sense of the word, but I was also grateful.

So I did what I did before when I was depressed: I took it one day at a time. One day, I was feeling well enough to watch an hour of TV so I did that. The next day, I incorporated reading back into my daily routine. Staying awake and forcing myself to feel alive one extra hour at a time. Eventually, I felt well enough to start going for walks again, and as soon as I started incorporating physical activities back into my routine, the pain from fibromyalgia and pregnancy slowly went away. I still cannot do more than a thirty-minute walk, otherwise the pain shoots right on back, but just being outside and smelling the fresh air (when there is not enough people around to have to keep my mask on) was enough to alleviate my mood.

Of course, this is not without my healthcare team’s constant observation. My husband actually calls them my TEAM AVENGERS. I have an in-person doctor’s appointment at least once a week, a virtual appointment with my therapist every two weeks, and my psychiatrist at least once a month.

All in all, this long post about medication has been to continue to inspire you that YES, our medications have been a great support throughout our treatment, but if you do need to let some go, DO NOT BE AFRAID. You are not alone – as long as you have your healthcare team, your support (my husband or your friends), you can power on through! We are #bipolarstrong and are happy and proud, just to be!

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